View Information Collection (IC)

View Information Collection (IC)

GenIC #7 (Revised): Cycle Vb (Final Report Template for the Round III AI/AN Cooperative Agreements), Cycle Va (Semi-Annual Template), and Cycle Vb (Monthly and Final Report Templates) CMCS
 
New
 
Mandatory
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form CMS-10398 #7 HEALTHY KIDS Cycle Va: Semi-Annual Report Template (qualitative report) HEALTHY KIDS Cycle Va SAR Template with PRA Disclosure.docx Yes Yes Fillable Fileable
Form CMS-10398 #7 HEALTHY KIDS Cycle Vb: Final Report Template (qualitative report) HEALTHY KIDS Cycle Vb Final SAR Template with PRA Disclosure.docx Yes Yes Fillable Fileable
Form CMS-10398 #7 MACRA Cycle Vb, Round III: Final Report Template MACRA Cycle Vb Round III Final Report Template.docx Yes Yes Fillable Fileable
Form CMS-10398 #7 HEALTHY KIDS Cycle Vb: Monthly Report Targets vs Other (quantitative reporting) Monthly report - targets vs other v9_1.11.19.xlsm Yes Yes Fillable Fileable
Form CMS-10398 #7 HEALTHY KIDS Cycle Vb: Monthly Report (quantitative reporting) Monthly report v41_1.11.19.xlsm Yes Yes Fillable Fileable

Health Health Care Services

 

47 0
   
State, Local, and Tribal Governments
 
   100 %

  Approved Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 1,634 0 1,634 0 0 0
Annual IC Time Burden (Hours) 5,258 0 5,258 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Crosswalk Crosswalk.xlsx 08/16/2019
GenIC Supporting Statement GenIC 7 - Supporting Statement (2019 version 5).docx 08/16/2019
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.